Are Check-ups worthwhile?

For many of our patients, the end of the year is “check-up” time.  Unfortunately, there is so much BS written about the whole concept of routine check-ups, that I just have to add my two BahtSworth (and not contracted to BS either). Simple fact: Check-ups do play an important part in Preventive Medicine.  This is the real situation.  Ignore the doom-sayers and the financial conspiracy theorists. Every year I hear people expound on the principle that they would rather not know about any underlying or sinister medical conditions they may have.  After all, we are all going to die one day, aren’t we?  I have always said that despite all advances in medical science, the death rate will always be the same – one per person! However, check-ups are inherently involved in that important feature called the Quality of Life.  Longevity alone, with no quality, just isn’t worth it in my book. The guiding principle behind check-ups is to find deviations from normal health patterns at an early stage.  Early enough that the trend can be reversed, before damage has occurred.  Examples of this include Blood Pressure (BP), a significant factor in poor health in the future if unchecked now.  High BP can affect many organs in the body, not just the heart.  But an elevated BP generally gives no warning symptoms – unless you go looking. Another example is blood sugar.  Again, it requires sky-high sugar levels before the person begins to feel that something might be wrong.  And by then the sugar levels have affected vision, the vascular system and many other systems, all of which can decrease your Quality of Life in the future.  Amputation of a limb is a common result of unchecked blood sugar levels.  Life in a wheelchair is hardly a good Quality of Life. Cardiac conditions and abnormalities, be that in anatomy or function, can also very adversely affect your future Quality of Life, but are very easily found during a routine check-up.  Various blood tests and an ECG can show just how well the cardiac pump is functioning, and give an indication as to how well it will continue to function in the future.  The inability to walk more than 50 meters certainly takes the fun out of shopping, yet this can be predicted – if you have some serial records! Another of the silent killers can be discovered in your lipid profile, with Cholesterol and its fractions HDL and LDL, being intimately connected with your cardiac status.  Again a situation where detecting abnormalities now can mean that you can get through the deadly 50-60 year age bracket in the future with clear coronary arteries and a clean bill of health. There are actually so many of the conditions that can affect your enjoyment of the future that can be discovered early.  Renal (kidney) function and liver function can be monitored through an annual check-up, as can prostate size (indicated by the PSA blood test) or breast tumors (by mammogram). The ultimate value in Check-ups lies in serial values of specific tests.  It then becomes easy to spot trends which will produce problems in the future. A future with a good Quality of Life.